Uterine polyps are abnormal growths of tissue that grow out of the membrane lining of the uterus. Most polyps are noncancerous, while some may be malignant.
Polyps may occur spontaneously or because of high levels of estrogen hormone, although it is not known what actually causes it. Polyps grow faster during pregnancy and while using oral contraceptives or estrogen replacement therapy. Although most polyps are noncancerous, the polyps that develop in women during or after menopause may become cancerous. Uterine polyps are more common in women aged 40 to 50 years; however, they occasionally may be seen in younger women of 20 years or less. Obesity, uncontrolled hypertension and certain drugs used to treat breast cancer may increase the risk of uterine polyps.
The most common symptom of uterine polyps is irregular menstrual periods: menorrhagia or abnormal heavy menstrual bleeding, prolonged periods, bleeding between periods and bleeding even after menopause or during sexual intercourse. Infertility may also be an indication of the presence of a uterine polyp.
Uterine polyps are diagnosed based on the patient’s medical history and symptoms. Other diagnostic tests such as transvaginal ultrasound (a kind of pelvic ultrasound used to look at a woman's reproductive organs), biopsy (removal of tissue from the body for examination) and curettage (removal of tissue with a curette) may be performed.
Smaller polyps that do not cause any problems should be assessed every 6 months to check their progression. However, if uterine polyps cause heavy menstrual bleeding or infertility, or if there is previous history of miscarriage, then removal of uterine polyps (polypectomy) may be considered. Usually, polypectomy may be performed at your doctor’s office using hysteroscopy during which a long, thin rod with a video camera and light (hysteroscope) is inserted through the vagina and cervical opening. The polyp is held and cut with a small scissor.
Larger polyps need to be operated on in a hospital setting under general anaesthesia. In order to remove the uterine polyps, laparoscopy may be performed along with a hysteroscopy. Laparoscopy involves the use of a laparoscope, a long rigid tube with a video camera and light which is inserted through a small incision made in the belly button. Through the laparoscope, special surgical instruments can be inserted, which assist in the removal of the polyps.